“I predict future happiness for Americans, if they can prevent the government from wasting the labors of the people under the pretense of taking care of them.” -- Thomas Jefferson

“Obamacare” is the government taking over our health care system on the pretense government will take care of us. Unfortunately, our health care system is not better since the inception of the Affordable Care Act.

Massachusetts residents pay among the highest health insurance rates in the entire nation. Last month we learned that rates nationally are growing at an average of 25 percent next year. The rising costs are pricing out families, seniors, and small businesses. Obamacare needs to be replaced.

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Government bureaucracy doesn’t make you healthier. It just raises the costs through reduced competition, diminishes access, and lowers the quality of care.

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Are more regulations requiring coverage within health care plans helpful? Some are. Some are not. If you are 60, you probably don’t need pediatric dental care coverage. Unfortunately, the rigid requirements of Obamacare dictate this coverage. How do regulations like that happen?

According to data from the Center for Responsive Politics, Blue Cross Blue Shield spent $23 million on lobbying in 2015. Overall, $510 million was spent on health care lobbying. Hence, government is picking profitable regulations for insurance companies, not seeking the best outcomes for patients.

As a citizen you cannot buy health insurance policy across state lines. Some states require coverage such as acupuncture and fertility treatments. If you don’t want this coverage, you cannot go across state lines where this coverage is not mandated. Your decisions are limited by government. You cannot self-determine your coverage.

Did Obamacare solve the problem of people getting insurance? Not really. Yes, more people have coverage, but most of them have ended up on a government program. A Heritage Foundation study found that in 2014, 9.25 million more Americans had health insurance coverage due to Obamacare but most of that was due to people being added to Medicaid. It said the net change for private market coverage was just 260,000 people.

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Increasing government control over health care isn’t the answer. Health care should be centered around the patient.

NO

Philip W. Johnston

Marshfield resident, former state Secretary of Human Services and New England administrator for the US Department of Health and Human Services

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Philip W. Johnston

If we’ve learned anything from Donald Trump’s political ascendancy, it is that he is remarkably vague about the specifics of public policy. In the case of health policy, this is especially true; thus far, all we know for sure is that he wants to “repeal and replace” the Affordable Care Act.

In doing so, however, he recently told 60 Minutes he intends to retain the exclusion of pre-existing condition clauses in private health insurance policies, and wants to keep the provision that younger people can remain on their parents’ policies until age 26. Further, he insists the law will be rewritten to ensure consumers won’t have to worry about a lapse in coverage between the current law and the Republican alternative. Of course, Trump is cherry-picking the more popular aspects of Obamacare while attempting to persuade the public that, as he told interviewer Lesley Stahl, “It will be great health care and much less expensive.” Certainly, that remains to be seen — but most people with experience dealing with health policy, myself included, are very skeptical.

The reason Trump’s plan won’t work financially is that Republican leaders in Congress will demand the evisceration of the individual mandate. That mandate is significant because it guarantees a reasonable mix of young, healthy members and older, sicker members. Without it, the mix would be skewed toward older, less healthy people, and premiums are likely to skyrocket.

All Americans also need to be very worried about House Speaker Paul Ryan’s continuing attempts to undermine Medicare by privatizing it. This is an enormously popular program which has provided comprehensive health services to millions of our citizens since 1965. Even Donald Trump has expressed opposition to Ryan’s radical plan. The danger is that Trump might be forced to support it in the political negotiations around gutting the Affordable Care Act.

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In Massachusetts, we should take some comfort that our health reform program operates very successfully. All children have insurance, and only 2 percent of adults remain uncovered.

Research shows Massachusetts citizens believe everyone should have access to high-quality, affordable health insurance. Let us hope the new Republican power structure does not tear asunder that same principle embedded within the ACA, which provides health insurance to nearly 25 million Americans.

Last week’s Argument: Should the state Gaming Commission revisit the Brockton casino plan?